Individual
LISA DIANNE CHURCHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9500 DORCHESTER RD STE 362, SUMMERVILLE, SC 29485-4304
(843) 212-8080
(843) 212-8091
Mailing address
PO BOX 632516, CINCINNATI, OH 45263-2516
(888) 472-0043
(513) 653-4122
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19849
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3767
—
SC
Enumeration date
03/09/2016
Last updated
04/23/2026
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